Provided herein are systems for treating tissue of a patient. The system comprises an energy delivery console and at least one energy delivery device. The energy delivery console can provide a first dose of energy and a second dose of energy. An energy delivery device comprises a first delivery element configured to deliver the first dose of energy to target tissue, and a second delivery element configured to deliver the second dose of energy to the target tissue. The first dose of energy can comprise a delivery of energy that reversibly alters the target tissue, and the second dose of energy can comprise a delivery of energy that irreversibly alters the target tissue. The first dose of energy can be delivered to enhance a therapy provided by the second dose of energy.

The present disclosure relates generally to the field of medical devices. In particular, the present disclosure relates to devices and methods to guide delivery devices and instruments. Exemplary instrument guides, including for endoscopes as delivery devices for cryogen delivery catheters and to guide cryogen decompression tubes as instruments, and methods for use of such instrument guides for use in body lumens at treatment sites, are disclosed.

Described herein are systems and methods for performing optical signal analysis and lesion predictions in ablations. A system includes a catheter coupled to a plurality of optical fibers via a connector that interfaces with a computing device. The computing device includes a memory and a processor configured to receive optical measurement data of a portion of tissue from the catheter. The processor identifies one or more optical properties of the portion of tissue by analyzing the optical measurement data and determines a time of denaturation of the portion of tissue based on the one or more optical properties. A model is created to represent a correlation between lesion depths and ablation times using the time of denaturation, the one or more optical properties, and the predetermined period of time. A predicted lesion depth for a predetermined ablation time is generated using the model.

A method for anesthetizing a human patient undergoing surgery and/or pain block procedure, the method comprising sterilizing the patient's skin including a target region, the target region including a surgical site including the patient's spine; inserting at least one cryo-needle into a first tissue region, the cryo-needle having a distal end configured to cool surrounding patient tissue, the first tissue region comprising soft tissue superficial to the one or more vertebra and on a first lateral side of the patients spine; cooling the distal end of the cryo-needle to cause cooling of surrounding patient tissue thus inhibiting one or more sensory nerves in the surrounding patient tissue; thereafter, performing spinal surgery on the patient's spine at the surgical site; and, thereafter, performing an erector spinae plane block to further inhibit nerves post-operatively in the target region.

Damaged, diseased, abnormal, obstructive, cancerous or undesired neural tissue treated by delivering specialized pulsed electric field (PEF) energy to target tissue areas. In some instances, the target tissue includes a tumor, a benign tumor, a malignant tumor, a cyst, or an area of diseased tissue. Most brain and spinal cord tumors develop from glial cells. These tumors are sometimes referred to as a group called gliomas. They arise from the supporting cells of the brain, called the glia. These cells are subdivided into astrocytes, ependymal cells and oligodendroglial cells (or oligos). One difficulty in the treatment of gliomas is that they are behind the blood-brain barrier (BBB) and blood-tumor barrier (BTB) which leads to poor delivery of anti-cancer drugs or immune agents to the tumor-infiltrated brain. Devices, systems and methods are provided that treat the tumor directly, such as by ablation, and optionally transiently disrupt the BBB coupled with adjuvant antibody, biologic, or other pharmaceutical interventions.

Methods for treating and managing pain in a patient with therapeutic neuromodulation and associated systems and methods are disclosed herein. Chronic or debilitating pain can be associated, for example, with a disease or condition of the abdominal or reproductive viscera. One aspect of the present technology is directed to methods that at least partially inhibit sympathetic neural activity in nerves proximate a target blood vessel of a diseased or damaged organ of a patient experiencing pain. Targeted sympathetic nerve activity can be modulated at least along afferent pathways which can improve a measurable parameter associated with the pain of the patient The modulation can be achieved, for example, using an intravascularly positioned catheter carrying a therapeutic assembly, e.g., a therapeutic assembly configured to use electrically-induced, thermally-induced, and/or chemically-induced approaches to modulate the target sympathetic nerve.

Devices, systems, and methods for the localization of body lumen junctions and other intraluminal structure are disclosed. Various embodiments permit clinicians to identify the locations of intraluminal structures and medical devices during non-surgical medical techniques, by determining the conductance and/or cross-sectional area at a plurality of locations within the body lumen.

A device, system, and method for treating an area of tissue and evaluating lesion formation and quality. The system may include a medical device having a plurality of mapping electrodes on a treatment element, the plurality of mapping electrodes being configured to record from the area of tissue at least one of unipolar impedance measurements, bipolar impedance measurements, local electrical activity, and pace threshold measurements before, during, and after circulation of the cryogenic fluid within the treatment element. These measurements may be transmitted to a control unit having processing circuitry configured to compare pre-treatment measurements, in-treatment measurements, and/or post-treatment measurements to each other and/or to threshold values to determine occlusion and/or lesion quality, such as lesion transmurality.

An intravascular catheter for nerve activity ablation and/or sensing includes one or more needles advanced through supported guide tubes (needle guiding elements) which expand to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the extra-luminal tissue including the media, adventitia and periadvential space. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall. Electrodes at the distal ends of the guide tubes allow sensing of nerve activity before and after attempted renal denervation. In a combination embodiment ablative energy or fluid is delivered to ablate nerves outside of the media.

The present disclosure relates to mapping catheters, and in particular to mapping catheters having thin film electrodes used in sensing electrical activity within a patient. Particularly, aspects of the present disclosure are directed to a medical device having a hollow core, a balloon disposed over at least a portion of the hollow core, and a flexible framework having one or more thin film elements formed on at least a portion of the balloon. The one or more thin film elements comprise a plurality of mapping electrodes.